Publish in this journal
Journal Information
Vol. 33. Issue 5.
Pages 219-226 (September - October 2022)
Share
Share
Download PDF
More article options
ePub
Visits
...
Vol. 33. Issue 5.
Pages 219-226 (September - October 2022)
Clinical Research
Preoperative 3D volume reconstruction of the posterior wall of the sphenoid sinus with Horos: A free, simple and reliable tool in endoscopic endonasal trans-sphenoidal surgery
Reconstrucción volumétrica 3D preoperatoria de la pared posterior del seno esfenoidal con Horos: una herramienta gratuita, sencilla y fiable en la cirugía endoscópica endonasal transesfenoidal
Visits
...
Francesco Paglia, Alessandro Caporlingua, Daniele Armocida
Corresponding author
danielearmocida@yahoo.it

Corresponding author.
, Francesca Rizzo, Antonio Santoro, Luca D’angelo
Human Neurosciences Department, Neurosurgery Division, “Sapienza” University, Italy
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (4)
Show moreShow less
Abstract
Background

The purpose of the study was to create computer-aided design models of the sphenoid sinus with a free-source software in order to perform a preoperative planning during trans-sphenoidal endoscopic surgery (TES) and clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures.

Methods

For each patient a 3D volume rendering of the sphenoid sinus was obtained from a thin slice head and maxilla-facial CT scan using a free-source DICOM viewer. The 3D models obtained preoperatively were examined preoperatively by six neurosurgeons in order to identify the boundaries of the sella.

Results

For the main anatomical landmark, all of the observers were able to recognize the anatomical structure at a rate ranging from 80 to 98%, 28 to 60% and 25 to 58% for expert (n=3), inexpert (n=3) and the entire group of observers (n=6), respectively. The analysis of the data shows that both observation groups presented a lower recognition rate of the following parameters: right and left medial and lateral optocarotid recesses and tumor prominence, however, the sellar prominence, clival recess, planum sphenoidalis, right and left ICA prominence, right and left optic prominences represent the main anatomical landmarks to be recognized during TES immediately before the opening of the sellar floor.

Conclusions

The use of a preoperative 3D imaging is not in itself a novelty in the literature, however the fact that a simple tool obtained with a free-source software like Horos can represent a considerable help in surgical practice without resorting to the use of more complex software and expensive represents the real utility of this work.

Keywords:
Neurosurgery
Pituitary gland
Transphenoidal approach
Brain tumor
Neuroendoscopy
Intrasellar region
Resumen
Antecedentes

El objetivo del estudio es crear modelos de diseño asistido por ordenador del seno esfenoidal con software de código abierto para realizar la planificación preoperatoria durante la cirugía transesfenoidal endoscópica (TES) y dilucidar las características anatómicas tridimensionales del seno esfenoidal y las estructuras que lo rodean.

Métodos

Para cada paciente, se obtuvo una representación volumétrica en 3D del seno esfenoidal, a partir de una tomografía computarizada maxilofacial de corte fino utilizando un visor DICOM de fuente libre. Los modelos 3D obtenidos antes de la cirugía fueron revisados por seis neurocirujanos para identificar los límites de la silla turca.

Resultados

Para el principal punto de referencia anatómico, todos los observadores fueron capaces de reconocer la estructura anatómica en un rango de 80 a 98%, 28 a 60% y 25 a 58% para los experimentados (n=3), los inexpertos (n=3) y todo el grupo de observadores (n=6), respectivamente. El análisis de los datos muestra que ambos grupos de observación presentaron una tasa de reconocimiento menor de los siguientes parámetros: recesos optocarotídeos medial y lateral izquierdo y prominencia tumoral, sin embargo, prominencia selar, receso clival, plano esfenoidal, prominencia ICA derecha e izquierda. Las prominencias ópticas derecha e izquierda representan los principales puntos de referencia anatómicos que deben reconocerse durante la TES inmediatamente antes de la apertura del suelo selar.

Conclusiones

El uso de una imagen 3D preoperatoria no es en sí mismo una novedad en la literatura, sin embargo, el hecho de que una simple herramienta obtenida con un software de código abierto como Horos pueda representar una importante ayuda en la práctica quirúrgica, sin tener que recurrir al uso de un software más complejo y costoso, representa la verdadera utilidad de este trabajo.

Palabras clave:
Neurocirugía
Glándula pituitaria
Abordaje transesfenoidal
Tumor cerebral
Neuroendoscopia
Región intraselar

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?